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Changwei Liu Children’s Hospital of Nanjing Medical University, Nanjing, China

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Jingwen Wang Children’s Hospital of Nanjing Medical University, Nanjing, China

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Yuanyuan Wan Children’s Hospital of Nanjing Medical University, Nanjing, China

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Xiaona Xia Children’s Hospital of Nanjing Medical University, Nanjing, China

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Jian Pan Children’s Hospital of Nanjing Medical University, Nanjing, China

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Wei Gu Children’s Hospital of Nanjing Medical University, Nanjing, China

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Mei Li Children’s Hospital of Nanjing Medical University, Nanjing, China

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Background Type 1 diabetes mellitus (T1DM) is an autoimmune disease occurring in the pancreatic islets. The disease can affect people of any age, but onset usually occurs in children or young adults, which accounts for 90% of diabetes in

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Li Qian Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China

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Yuxiao Zhu Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China

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Yan Luo Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China

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Mu Zhang Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China

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Liping Yu Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA

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Yu Liu Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China

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Tao Yang Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China

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Introduction Type 1 diabetes mellitus (T1DM) is well-defined as one of the most common and lifelong autoimmune diseases characterized by pancreatic β-cell destruction ( 1 , 2 ). Several autoantibodies, such as glutamic acid decarboxylase

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Marie Reeberg Sass Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Nicolai Jacob Wewer Albrechtsen Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark

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Jens Pedersen Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Endocrinology and Nephrology, Nordsjællands University Hospital, Hillerød, Denmark

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Kristine Juul Hare Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Nis Borbye-Lorenzen Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Center for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark

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Katalin Kiss Department of Pathology, Rigshospitalet, Copenhagen, Denmark

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Tina Vilsbøll Steno Diabetes Center Copenhagen, Gentofte, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Filip Krag Knop Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Steno Diabetes Center Copenhagen, Gentofte, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Steen Seier Poulsen Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Niklas Rye Jørgensen Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Jens Juul Holst Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Cathrine Ørskov Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Bolette Hartmann Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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with mean and s.d. For panel B, *represent statistical significant difference using an unpaired t -test, whereas for panel D, *represent statistical significant difference using a paired-test. Data are illustrated as mean ±  s.e.m. n  = 9/8 (T1DM

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W Liu Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China

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Y Wang Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China

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X Han Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China

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X Cai Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China

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Y Zhu Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China

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M Zhang Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China

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S Gong Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China

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J Li Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China

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L Ji Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China

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Introduction Chronic complications cause the largest proportion of deaths and increase in prevalence with the duration of the disease in long-standing type 1 diabetes (T1DM). ( 1 ) Indeed, the duration of diabetes and severity of hyperglycemia

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Xiuzhen Zhang Department of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China

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Dan Xu Department of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China

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Ping Xu Department of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China

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Shufen Yang Department of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China

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Qingmei Zhang Department of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China

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Yan Wu Department of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China

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Fengyi Yuan Department of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China

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Introduction Amongst the background of the rising incidence of type 1 diabetes mellitus (T1DM) across the globe, public concern has reached a new high ( 1 ). Despite progress in diabetes care, as the leading cause of mortality in T1DM ( 2

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Taís S Assmann Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
Postgraduation Program in Medical Sciences: Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

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Mariana Recamonde-Mendoza Institute of Informatics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

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Bianca M De Souza Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
Postgraduation Program in Medical Sciences: Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

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Daisy Crispim Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
Postgraduation Program in Medical Sciences: Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

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Introduction Type 1 diabetes mellitus (T1DM) is characterized by autoimmune destruction of pancreatic beta-cells by T lymphocytes and macrophages ( 1 ). The disease is usually diagnosed when over 80–90% of beta-cells have been destructed by

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Stavroula A Paschou Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, ‘Aghia Sophia’ Children’s Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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Nektaria Papadopoulou-Marketou Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, ‘Aghia Sophia’ Children’s Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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George P Chrousos Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, ‘Aghia Sophia’ Children’s Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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Christina Kanaka-Gantenbein Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, ‘Aghia Sophia’ Children’s Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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Introduction Type 1 diabetes mellitus (T1DM) represents only around 10% of the diabetes cases worldwide, but occurs with increasing incidence much earlier in life. T1DM results from the autoimmune destruction of β cells of the endocrine

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Yun Cai Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Jieni Yan Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Yong Gu Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Heng Chen Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Yang Chen Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Xinyu Xu Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Mei Zhang Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Liping Yu Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA

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Xuqin Zheng Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Tao Yang Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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DM) is the most frequent ( 3 , 4 , 5 ). The phenotype is referred as autoimmune polyendocrine syndrome type II (APS II) when T1DM and AITD occur in the same individual, even sometimes coexist in the same family ( 6 , 7 ). T1DM, as well as AITD

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Lili Liu Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
Key Laboratory of Diabetes Immunology, Central South University, Ministry of Education, National Clinical Research Center for Metabolic Diseases, Changsha, Hunan, China

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Zhuo Shao Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, Shanghai, China

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Ying Xia Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
Key Laboratory of Diabetes Immunology, Central South University, Ministry of Education, National Clinical Research Center for Metabolic Diseases, Changsha, Hunan, China

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Jiabi Qin Department of Epidemiology & Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China

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Yang Xiao Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
Key Laboratory of Diabetes Immunology, Central South University, Ministry of Education, National Clinical Research Center for Metabolic Diseases, Changsha, Hunan, China

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Zhiguang Zhou Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
Key Laboratory of Diabetes Immunology, Central South University, Ministry of Education, National Clinical Research Center for Metabolic Diseases, Changsha, Hunan, China

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Zubing Mei Department of Anorectal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China

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Introduction Type 1 diabetes mellitus (T1DM), which is caused by the selective destruction of the insulin-producing β cells located in the pancreatic islets of Langerhans, is one of the most common and debilitating autoimmune diseases ( 1

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Punith Kempegowda Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Eka Melson Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Agnes Johnson College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

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Lucy Wallett College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

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Lucretia Thomas College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

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Dengyi Zhou College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

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Catherine Holmes University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Agata Juszczak University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Mohammed Ali Karamat University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Sandip Ghosh University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Wasim Hanif University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Parth Narendran University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK

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Srikanth Bellary University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
School of Life and Health Sciences, Aston University, Birmingham, UK

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times greater mortality from COVID-19 for those with type 2 diabetes (T2DM) and 3.5 times in those with type 1 diabetes mellitus (T1DM) compared to those without diabetes ( 2 ). Importantly, the majority of these deaths occurred in the elderly, and the

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